Study And Application Of Nursing Education Model Of Project-based Learning

ObjectivesTo know knowledge level and attitude of undergraduated students to nursing research education,and to offer theoretical basis to education study of nursing research,two investigations are conducted,the one is about nursing research and correlative curriculums of 15 nursing schools in China,the other one is about knowledge level and attitude of 2005 grade undergraduated students in Nanfang medical university to nursing research education.Aim at the problems of nursing research education and limits of problem-based learning,we have been built nursing education model of project-based learning(PBL) in undergraduated students education.Application of nursing education model of PBL,in the light of evidence-based nursing(EBN),the teachers conduct students to system review,study questionnaires,many-centers investigate to the patients of impaired glucose regulation(IGR),diabetes,and abdominal operation,and build website of Nanfang health education in order to supply theoretical and practical basis to personal health education of the patients of IGR,diabetes,and abdominal operation.MethodsChapterⅠsectionⅠ:Investigation by email,about nursing research and correlative curriculums of 15 nursing schools in China,its questionnaire include 6 factors:curriculums teaching about nursing research,bibliography search,nursing papers writing,epidemiology,medical statistics,others correlative curriculums of nursing research.Each factor includes 4 items need answer if this course has been conducted,the number of course hours,the time of course begin,teaching books, teachers(include number,education certificate,the title of a technical post,age and teaching time);sectionⅡ:the questionnaire to 120 nursing undergraduated students of 2005 grade in Southern medical university,include two sections:the one is 22 test questions need to single choice of nursing research knowledge,the other one is 4 test questions need to single choice of nursing research attitude;ChapterⅡ:base on investigative data of chapterⅠ,we plan teaching program and objectives,study nursing education model of project-based learning of two learning groups of undergraduated students.Teaching methods have symposium,timely email,QQ etc. Teaching program include the project divided into two domains,the questions confirmed,study background of the project introduced,research thinking directed, English bibliographies searched and selected if those are middle difficulty,teaching objectives and methods planed,test objectives different period established,teaching fields communicated,teaching outlay budgeted by teacher.Each student chooses a question,search and read papers,writes concluding report,and reviews the new development about the question,based on the review and concluding report,studies questionnaires and investigates about health demands of patients of IGR,diabetes, and abdominal operation,plans and builds website of the Nanfang health education together teachers;ChapterⅢsectionⅠ:under the EBN thesis directing,in the light of system review about condition and research outcomes of the health education of IGR and diabetes patients,we find the questions about the health education of them, many-centers investigate the health education demands to them.After reading foreign and Chinese references,consulting a psychologist,a statistician and three nursing specialists,investigating in advance,we plan and revise questionnaire by oneself.The questionnaire includes three sections,general condition,the health education demands and the methods of health education demand of IGR and diabetes patients. The general condition of IGR and diabetes patients include gender,age,nationality (the Han nationality and minority),culture level(high culture level,middle culture level,and primary culture level),classification of medical expenditure(expenditure by oneself and not by self) and occupation(the worker of physical strength and brainworker),illness time,diagnose,the number of complications.The health education demands of IGR and diabetes patients include eight factors:general(have ten items),dietary(have six items),sportive(have three items),health educative (have two items),inspective by oneself(have three items),complications of(have two items),pharmic(have six items) and directive leaving hospital(have an item) knowledge demand of diabetes.Each item need single choice divides into five grades: need very much,need,not at all,no need very much,no need.The methods of health education demand of IGR and diabetes patients include fourteen items.Each item not need single choice have two choices:yes and no.The teachers educating investigators are the first group CNS in China,their graduation being from graduated student's refresher course of the CNS in southern medical university of Guangdong province. The investigators are teached by diabetes nursing,the choice major course in southern medical university.Eight investigators having been unified terms and divided into four groups explain the content and requirement of the questionnaires to IGR and diabetes patients,the questionnaires are filled in.If the patients are illiteracy,the investigators record the investigative result according to statement of the patients.The investigators receive the questionnaires after the patients on the ground have filled them out.The statistical data are analyzed by SPSS13.0 software,statistical methods include reliability of homogeneity and construct-related validity analysis,frequencies and descriptive statistics,ordinal logistic regression,binary logistic regression, Wilcoxon nonparametric test of 2 related samples,Friedman nonparametric test of K related samples.In term of system review about condition and research outcomes and investigation of the health education of IGR and diabetes patients,we study the internet means of health education and nursing clinics of network serving them; sectionⅡ:under the EBN thesis directing,in the light of system review about condition of the health education of abdominal operation patients,we find the questions about the health education of them,many-centers investigate the health education demands to them.After reading foreign and Chinese references,consulting a psychologist,a statistician and three nursing specialists,investigating in advance, we plan and revise questionnaire by oneself.The questionnaire includes six sections: general condition,the preoperational health education demands,post-operation,and direction of leaving hospital and the fondest methods of health education demand and leaving hospital of abdominal operation patients.The general condition of abdominal operation patients includes gender,age,nationality(the Han nationality and minority), culture level(high culture level,middle culture level,and primary culture level), classification of medical expenditure(expenditure by oneself and not by self) and occupation(the worker of physical strength and brainworker),post-operative time, anaesthetic patterns(local and systemic anaesthesia),the grades of pain(0～7 grades). The second section includes eleven items.The third section includes 3 items.The forth section includes 1 item.Each item need single choice divides into five grades: need very much,need,not at all,no need very much,no need.The fondest methods of health education demand and leaving hospital of abdominal operation patients includes respectively 8 and 9 items.Each item not need single choice have two choices:yes and no.Twelve investigators having been unified terms and divided into six groups,explain the content and requirement of the questionnaires to abdominal operation patients,the questionnaires are filled in.If the patients are single or illiteracy or activity inconvenienced,the investigators record the investigative result according to statement of the patients or their family numbers.The investigators receive the questionnaires after they have filled them out on the ground.The statistical data are analyzed by SPSS13.0 software;statistical methods include reliability of homogeneity and construct-related validity analysis,frequencies and descriptive statistics,ordinal logistic regression,binary logistic regression,Wilcoxon nonparametric test of 2 related samples,Friedman nonparametric test of K related samples.In term of system review about condition and investigation of the health education of abdominal operation patients,we study the Internet means of health education serving them,combining nursing website of the diabetes to form a network of Nanfang health education.We apply adequately multimedia functions(images, graphics,actions,radios,etc) to website building,and introduce the surrounding of exploring and application,materials source,plan thinking,framework and contents of the web.Results ChapterⅠsectionⅠ:there are 13 nursing schools to have conducted nursing research curriculum in 15 nursing schools of this study.The number of course hours is 30～64;mean course hours are(38.92±11.36).The teacher is mainly graduated student.There is the teaching book.However,the age and the title of a technical post of teachers,the index reflect research and education experience,are not very good. The nursing teachers are not competent for correlative curriculums of nursing research.The bibliography search is not conducted very well;however,it is correlative with nursing research ability of undergraduated students.Compare to it, medical statistics is attached importance to.The teaching program of nursing research and correlative courses is confusional.It is very different how many courses fitted nursing undergraduated students' educations for every nursing school;SectionⅡ:it are the great number of the students thinking the work of nursing research of being very important and important.It is explained that the students think much of the work of nursing research.A majority of students think arrangement of nursing research course and knowledge level of nursing research being held is common or not very well.The order of importance of educative methods about nursing research from high to low is lecture,taking part in research group,clinical practice,application for research project and self-study.In 22 test questions,there are only 7 questions,their correct rate exceeds 60 percent,and the correct rate of the other 15 questions is under 60 percent.The lowest scores are 5,and the highest scores are 16,mean scores are (10.48±2.50),it does not reach the half of total scores.It is consistent with results of the students self-judge.A great deal of the students is not plain to conception of nursing research;ChapterⅡ:in the nursing education model of project based learning, we use theoretical and practical test different period to teaching effective evaluation of students.The test include eligible rate of the number of writing paper,contents of the website,investigative questionnaires.One of scores of these three sections is 1/3 of the total scores.Through our study more than two years,there are six students to have published paper on core journals in China.Twenty students have finished conclusion and entrance of the materials of website(regulative rate is 92.06%),and 1450 investigative questionnaires(regulative rate is 88.07%).All they attain the critical credits of southern medical university.Therefore,our study conclude the nursing education model of project based learning which teachers and students enough use part time and many kinds of and active teaching methods,emphasize combination theory with practice,it is importantly complementary teaching model to regular lecture in class room;ChapterⅢ:application the nursing education model of project based learning in undergraduated student's study about health education. SectionⅠ:The reliability of homogeneity(Cronbach's alpha is 0.971,x~2=109.858, P=0.000) and construct-related validity of the questionnaire about health education demands of IGR and diabetes patients are very good.In general health education demands,those order of the patient hoping to know from high to low is therapy program,harm,dangerous effects,nursing plan,clinical findings,diagnosis regulation, prevention of diabetes,diagnosis regulation of IGR,terms and clinical classification of diabetes(P=0.000);Order of dietary health education demands the patient hoping to know from high to low is meaning of food therapy,methods selecting food, distribution of nutrition elements and eating frequence,method of food exchanging, means of caloric calculation,conception of GI(P=0.000);Order of sportive health education demands the patient hoping to know from high to low is meaning,key points of sportive therapy,and content of sportive prescription(P=0.000);Order of inspective by oneself health education demands the patient hoping to know from high to low is inspective method and frequence of plasma glucose,urine glucose,and inspective aim and method of HbAlc(P=0.000);Order of pharmic health education demands the patient hoping to know from high to low is prevention and therapy of action to low plasma glucose,side effect and using method of oral medicines decreasing plasma glucose,using method and key points of INS,kind of oral medicines decreasing plasma glucose(P=0.000).Compare to nurse,the patient is more hopeful to be offered health education by doctors(P=0.023).These demands of health education of the IGR and diabetes patient hoping to know are correlative with culture level(P＜0.05) to the terms(P=0.010,R~2=0.037),knowledges of three grades prevention(P=0.040,R~2=0.031),diagnosis(P=0.003,R~2=0.043),clinical classification(P=0.006,R~2=0.039),therapy program(P=0.037,R~2=0.033) of diabetes in general health education;conception of GI(P=0.013,R~2=0.036),methods selecting food(P=0.005,R~2=0.042) in dietary health education;meaning(P=0.049,R~2=0.031), key points(P=0.035,R~2=0.032) of sportive therapy,and content of sportive prescription(P=0.019,R~2=0.035) in sportive health education;offered health education by nurse(P=0.030,R~2=0.033) in health education;inspective method and frequence of plasma glucose(P=0.018,R~2=0.036),urine glucose(P=0.038, R~2=0.031),and inspective aim and method of HbAlc(P=0.021,R~2=0.033) in inspective by oneself health education;classification(P=0.007,R~2=0.041)and nursing (P=0.002,R~2=0.046) in complications health education;kind(P=0.003,R~2=0.045), using method(P=0.038,R~2=0.032) and side effect(P=0.022,R~2=0.035)of oral medicines decreasing plasma glucose,prevention and therapy of action to low plasma glucose(P=0.033,R~2=0.033) in pharmic health education and direction leaving hospital(P=0.006,R~2=0.041),the higher culture level,the most demand.Knowledges of three grades prevention of diabetes(P=0.040,R~2=0.031) in general health education demand is correlation with age(P=0.045),the less age,the more demand. These demands of health education of the IGR and diabetes patient hoping to know are correlative with nationality(P=0.014,P=0.011 respectively) to therapy program of diabetes(P=0.037,R~2=0.033) in general health education and side effect of oral medicines decreasing plasma glucose(P=0.022,R~2=0.035) in pharmic health education,Han nationality patients have more demand.These demands of health education of the IGR and diabetes patient hoping to know are correlative with illness time(P＜0.05)to methods selecting food(P=0.005,R~2=0.042) in dietary health education,meaning of sportive therapy(P=0.049,R~2=0.031) in sportive health education,offered health education by doctors(P=0.024,R~2=0.035) in health education,kind(P=0.003,R~2=0.045),using method(P=0.038,R~2=0.032) and side effect(P=0.022,R~2=0.035)of oral medicines decreasing plasma glucose,prevention and therapy of action to low plasma glucose(P=0.033,R~2=0.033) in pharmic health education,besides the more illness time,the more demand to know side effect of oral medicines decreasing plasma glucose,the less illness time,the more demand to know other six demands.Patients demands to inspective method and frequence of plasma glucose(P=0.018,R~2=0.036),and urine glucose(P=0.038,R~2=0.031 respectively) in inspective by oneself health education are correlation with occupation(P=0.005, P=0.032 respectively),the brainworker have more demands.Others regression equation of health education demand are P＞0.05.Order of the fondest means of health education to patient from high to low is clinics consultation of diabetes doctor, newspaper,journal,phone consultation,brochures and books posted from hospital, clinics consultation of diabetes nurse,lecture in hospital,medical and nursing home serve,Internet,communicative meet between nurse and patient,poster,the mobile phone short message service(SMS),video,CD-ROM,others(P=0.000).Demand to telephone consultation(P=0.014,R~2=0.045) of patients is correlation with age (P=0.013),gender(P=0.029),the less age,the more demand,and the male patient has more demands;Demand to SMS(P=0.022,R~2=0.062) is correlation with illness time, the shorter illness time,the more demand.Demand to Internet(P=0.000,R~2=0.213) is correlation with age(P=0.000),occupation(P=0.008) and the number of complications(P=0.000),the less age and complications,the more demand,and the brainworker have more demand to Internet.Demand to brochures and books posted from hospital(P=0.000,R~2=0.071) is correlation with the classification of medical expense(P=0.049) and occupation(P=0.011),the patients of expenditure not by self or brainworker have more demand.Demand to video(P=0.022,R~2=0.062) is correlation with the number of complications(P=0.009),the more complications,the more demand.Demands to CD-ROM(P=0.000,R~2=0.109),newspaper and journals (P=0.008,R~2=0.046) are correlation with culture level(P=0.014,P=0.000) and the number of complications(P=0.001,P=0.026),the high culture level,the more complications,the more demand.Demand to clinics consultation of diabetes doctor (P=0.034,R~2=0.035) is correlation with illness time(P=0.015),the number of complications(P=0.049),the longer illness time,the more complications,the more demand.Demand to lecture in hospital(P=0.002,R~2=0.063) is correlation with gender(P=0.034),age(P=0.012) and culture level(P=0.051),the bigger age,the higher culture level,the more demand,and the female patient has more demand. Demand to medical and nursing home serve(P=0.003,R~2=0.060) is correlation with occupation(P=0.000),the worker of physical strength has more demand.Others regression equation of health education demand are P＞0.05;SectionⅡ:Health requirement level of abdominal operation patients is very high at different period in hospital(entering hospital,preoperation,post-operation and direction leaving hospital).Contrast to charge nurse(P=0.000) and anesthetist(P=0.000),patients hope to most know the name,the title of a technical post,skill level of charge doctor.There is not deviation(P=0.124) between charge nurse and anesthetist of which patients hope to know the name,the title of a technical post,skill level.These demands of health education of the abdominal operation patient hoping to know are correlative with gender(P＜0.03) to the name,the title of a technical post,skill level of charge doctor(P=0.026,R~2=0.056) and anesthetist(P=0.000,R~2=0.124),regulation of the hospital(P=0.001,R~2=0.072),importance of preoperative examinations(P=0.005, R~2=0.066),important meaning of preoperative preparation(P=0.000,R~2=0.082), operative methods and procedure(P=0.000,R~2=0.096) in preoperational health education,the female patient has more demand.These demands of health education of the abdominal operation patient hoping to know are correlative with culture level (P＜0.04) to the name,the title of a technical post,skill level of charge doctor (P=0.026,R~2=0.056) and anesthetist(P=0.000,R~2=0.124),regulation of the hospital in preoperational health education(P=0.001,R~2=0.072) and operative patients about being noted if operative success(P=0.030,R~2=0.065),the higher culture level,the more demand to the three preoperational patient,and the lower culture level,the more demand to the post-operative patient.These demands of health education of the abdominal operation patient hoping to know are correlative with the classification of medical expense(P＜0.05) to nurse's direction to preoperative patients(P=0.000, R~2=0.083),operative name(P=0.029,R~2=0.053) in preoperational health education and operative patients about being noted if operative success(P=0.030,R~2=0.065) and direction leaving hospital(P=0.001,R~2=0.081),the patient of expenditure not by self has more demand.Two demands are correlation with anaesthetic patterns(P＜0.05) to regulation of the hospital(P=0.001,R~2=0.072) and important meaning of preoperative preparation(P=0.000,R~2=0.082) in preoperational health education,the patient of systemic anaesthesia has more demand.Preoperative demand to introduce surrounding of operation room(P=0.000,R~2=0.119) is correlation with nationality (P=0.043),the minority has more attention.Others regression equation of health education demand are P＞0.05.The fondest direction out hospital of patients is directly conducted by doctor[313(50.3%)].The telephone[230(37.0%)]was arranged second.The fondest means of acquiring health information by patients is introduced by nurse[307(49.4%)].Thus it can be seen,patients were fonder of communication with nurse face to face.Demand to telephone consultation(P=0.000, R~2=0.097) in direction out hospital of patients is correlation with gender(P=0.008), age(P=0.045),pain level(P=0.046) and anaesthetic patterns(P=0.000),local anaesthesia or female patient has more demand,the milder pain,or the less age,the more demand.Demand to directly conducted by doctor(P=0.000,R~2=0.071) in direction out hospital of patients is correlation with pain level(P=0.000) and age (P=0.006),the more serious or the bigger age,the more demand.In means of acquiring health information by patients,demand to introduced by nurse(P=0.000, R~2=0.108) is correlation with classification of medical expense(P=0.015),gender (P=0.041) and pain level(P=0.000),the milder pain,the more demand,the male patient or the patient of expenditure by self has more demand;demand to video (P=0.001,R~2=0.139) is correlation with gender(P=0.029) and anaesthetic patterns (P=0.020),systemic anaesthesia or female patient has more demand;demand to poster(P=0.006,R~2=0.068) is correlation with gender(P=0.028) and occupation (P=0.027),the female patient or brainworker has more demand;demand to Internet (P=0.000,R~2=0.085) is correlation with culture level(P=0.011),the higher culture level,the more demand.Result of website of Nanfang health education running show, it is stabilizing run on the WindowsXP operating system and IE6.0 browser,no run error or stoppable and character error.Put it out Internet,alternation of the website is good,no link error.ConclusionsChapterⅠsectionⅠ:the nursing teacher should perfect education about nursing research and correlative course in the future,strengthen teacher's trainability,and conduct teaching study of nursing research course.SectionⅡ:the teacher should inspire student's learning interest,deeply reform nursing research and correlative course,practice nursing research and education ability.SectionⅡ:nursing education model of project based learning can inspire student's learning interest for study individuation;group members can study each other for learning inter-influence;the teacher plans objectives of the outcomes for teaching by personal example as well as verbal instruction;the teacher builds diversified stage for information communication; the teacher multiform tests for cultivating synthesis ability to students.ChapterⅢsectionⅠ:because content has strong logicality and the number is suitable,the questionnaire can use evaluation the demands of health education to different IGR and diabetes patients.The patient considers importance order of the demand of health education is from easy to difficult,videlicet the patient arranges intelligible demand to ahead and indigestible those to back.Many patients are unaware of important terms and correlative knowledge and services of the doctors and nurses still are not deep in health education of IGR and diabetes patient.CNS should pertinently serve the demands of patients' health education to different disease stage;enough evaluate professional knowledge held by the patient and the effect factors,such as gender,age, nationality,culture lever,classification of medical expense,occupation,illness time, diagnose and the number of the complications before education,and stress management study of the patients to application of opening education patterns,such as video,CD-ROM,newspaper,journal and Internet,so that the nurse can improve compliance of the patients.Although nursing health education of diabetes patients still is not prevalent,with development of nursing education to CNS of diabetes,it has very expansively outlook.There is not website of diabetes specialty nursing. Although there are the Journal of diabetes specialty nursing and the institutional website,there is not a web clinic of diabetes nursing.In our study,the web clinic of diabetes nursing periodically serves to diabetes patients.The nursing specialists are the first group diabetes CNS in China brought up by us.SectionⅡ:because there are higher demands to abdominal operative patients,the nurses should pertinently serve the demands of patients' health education to different disease stage and explore personal,full-stage,excellent health education model;enough evaluate the effect factors,such as gender,age,nationality,culture lever,classification of medical expense,occupation,pain level,and anaesthetic patterns before education.Although demand to directly conducted by doctor and nurse and telephone consultation are fond,the nurses should study multimedia education methods,such as website, CD-ROM and video etc so that satisfying the demand of different patients.Because of expansively knowledge domain of abdominal operation,so far,there is not an absolute nursing website about abdominal operation.In terms of this study,demand to Internet is correlation with culture level,the higher culture level,the more demand, thus,it is very important to study and build nursing website about abdominal operation.Direction of this study will research more others methods of health education about IGR,diabetes,and abdominal operation in the light of evidence based result.